The University Physicians Healthcare Group, Tucson Arizona

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Start Your Registration Process Today
Step 1: Does Your Business Qualify? Step 2: Necessary Forms Step 3: Application Step 4: Acceptance

	Step 1:	The following questions will help you determine whether your business qualifies for coverage.
		Has your business been conducting business within the State of Arizona for at least 60 consecutive day
		Does your business have 1-50 employees or self-employed individuals working 20 hours or more per week.
		Will the minimum percentage of your employees be enrolled for coverage?

		If your business has 1-5 employees 100% of the eligible employees must be enrolled for coverage. If your business has 6 or more employees, at minimum of 80% of the eligible employees must be enrolled for coverage.

		Note: Employees with proof of other existing health care coverage who elect not to participate in HCG shall not be considered when determining the percentage if the other health care coverage is either other group health coverage through a spouse, parent or legal guardian or is coverage available from a government subsidized health care program.

	Step 2:	The HCG forms are provided by the state of Arizona. Click on the link below to open a new window with the appropriate forms.
		Click here to visit the State Website
		Please note: All of the forms are in PDF format, which requires Adobe Acrobat Reader. If you do not have Acrobat Reader, or are unsure if you have Acrobat Reader, click on the following picture to download and install it.


	Step 3:	Application
		Complete and mail the necessary forms, payment and any documentation to: Healthcare Group of Arizona 700 E. Jefferson Street, Suite 200 Phoenix, AZ 85034
		Premium Payment For One Or Two Months
		Sole Proprietors With No Paid Employees: Send one of the following acceptable proof of business documents Current Federal Income Tax Return with Schedule C Current Federal Income Tax Return with Schedule F Current Corporate Tax Return Current Sales Return Showing Active Sales Note: Additional documentation may be required.

		Sole Proprietors With Paid Employees: Send one of the following acceptable proof of business documents Current Federal Income Tax Return with Schedule C Current Federal Income Tax Return with Schedule F Current Corporate Tax Return Current Workers Compensation Report with Employee List Current Unemployment Tax and Wage Report with Employee List Current Sales Return Showing Active Sales Note: Additional documentation may be required.

	Step 4:	Acceptance
		Once you have been accepted into the program: Your business will receive a letter of acceptance from Health Care Group. Each employee enrolled will receive his/her membership card(s) at the address on record from the chosen health plan.